Nicotine replacement: ten-week effects on tobacco withdrawal symptoms

This study examined the long-term effects of nicotine replacement on tobacco withdrawal symptoms. Smokers (N=40 community volunteers) maintained biologically validated smoking abstinence under closely monitored conditions while chewing 2 mg nicotine gum (Nicorette; average of 6.9 pieces per day) or placebo gum during the first 10 weeks following smoking cessation. During the first postcessation week symptoms of irritability, anxiety, impatience, restlessness, excessive hunger, difficulty concentrating, drowsiness, sleep disturbance and tobacco craving intensity were significantly lower in active as compared with placebo nicotine gum subjects. Symptoms of psychological distress including irritability, anxiety and impatience declined over time in placebo subjects and were suppressed by replacement therapy below placebo treatment levels only during the first 4–5 weeks after smoking cessation. On other items, most notably increased appetite and excessive eating, stable between-group differences persisted over the entire 10-week trial. The data suggest that use of active gum beyond the first 5 weeks post-cessation may be inconsequential as far as suppression of certain key symptoms of psychological disturbance is concerned, but more prolonged use of active gum would be advisable if the long-term nicotine replacement effects observed (e.g. decreased hunger) are relevant to smoking relapse prevention.